Organization overview

Child Family Wellness Shops, also known as “The Healthstores”, are based on the business model of franchising. The organization, which is headquartered in Nairobi, seeks out “medical entrepreneurs”, who are usually nurses with at least ten years of clinical experience and also some small business experience. The RNs are then guided through the process of opening either a “healthstore”, which dispenses medications, or a healthstore plus clinic, which additionally provides basic clinical care. HQ provides managerial support, delivers medications to the shops/clinics, monitors and enforces a standard of care, and trouble shoots when the clinics are not meeting a minimum level of profitability. Designed to provide affordable and standardized care to the poor, the Healthstores provide consistent access to affordably priced quality medications, and quality controlled primary clinical care with minimal waiting times. Each consultation costs approximately 70 Kenyan schillings (1 USD). The system works because the franchise owner is invested in the clinic’s success, and must provide good care to ensure repeat visits from the community members.

Project descriptions and opportunities

1) Development of treatment algorithms The Healthstores aim to provide a high quality of care to clients. In order to accomplish this, Healthstores carries out trainings for clinic nurses, and uses treatment guidelines developed by the Kenyan Ministry of Health. To make the training process more effective, and to provide a standardised system for making diagnostic and treatment decisions, the Global Health Center is working with Healthstores to develop diagnostic/treatment algorithms for conditions that are commonly seen in the clinics. Implementation of these algortihms will involve training of clinic nurses, and introduction of a new charting system to the clinics, as well as future monitoring of how the new system is working. There are currently opportunities for students and residents to participate in the development and implementation of these algorithms.

2) Patient educational aid development In conjunction with the treatment algorithms for nurses or health workers mentioned above, “patient aids” are being developed. These will allow the patients to understand the treatment decisions which are being made for their given complaint. These instruments need to be intuitive, bridging language and educational barriers, and should complement the final treatment guidelines. There will be opportunities for students and residents to participate in the design, implementation and evaluation of these patient aids over the next 12 months.

3) Surveillance Basic records of chief complaint, diagnosis, and treatment rendered are kept in each of the 59 clinics. The management does not compile records of what complaints are seen, nor analyze the data to track prevalence of various diseases in their catchment areas. Compiling this data could help guide education efforts, inform equipment purchasing, identify new trends in diseases (for example the emerging threat of “lifestyle diseases”), and inform changes in healthcare delivery strategies. CFW is particularly interested in investigating the emergence of diabetes and hypertension in their communities, and in developing their primary care and referral systems to effectively deal with these chronic healthcare issues. Residents or students interested in needs assessment, disease surveillance, and health systems structure could participate in this process.

Logistics Transport from Nairobi to Embu or Kisumu, and on-site accomodation will be coordinated on an individual basis by the CFW directors and field staff. Airline tickets to Kenya cost approximately US$1500.

Read more at the official CFW website

Student and Resident Experiences at Healthstores

Dinali Fernando 2007